What are the precise reasons for the disparity in referrals to fitness to practise between international and UK medical graduates?

PURPOSE OF THE STUDY: To discover the precise reasons for referring a doctor to the Medical Practitioners Tribunal Service, and whether there are any disparities between referrals of international medical graduates and UK graduates. Further to consider whether understanding the precise reasons would provide insight into the nature of referrals. STUDY DESIGN: We collected and analysed the data from the Medical Practitioners Tribunal Service website over a period of 12 months. RESULTS: There were 228 cases of which 142 (62%) were international medical graduates and 86 (38%) were UK graduates. More international medical graduates were referred for professional misconduct, poor performance and lack of adequate English language. The common reasons for professional misconduct were providing sub-optimal care, sexual misconduct and dishonest behaviour. More UK graduates were referred following convictions due to offences related to alcohol intake and financial dishonesty. There is paucity of good quality information to identify the exact reasons for the disparity. CONCLUSION: More international medical graduates were referred to the Medical Practitioners Tribunal Service than UK graduates. There was disparity in the nature of the referrals and we hope our findings will inform employers and the regulatory bodies to understand that comprehensive induction, inclusion, mentoring and adjustments are needed to support international medical graduates to mitigate the risks of failure and help them to meet the required professional standards.

Prescribing - a worldwide survey on governance.

PURPOSE OF THE STUDY: To explore the governance regarding prescribing across the world. STUDY DESIGN: We used a web-based questionnaire to ask the doctors about their prescribing practices and perception of governance in relation to prescribing. We sent the questionnaire to all doctors working in our hospital and primarily targeted doctors who had acquired their medical qualifications outside the UK to get a global view. RESULTS: We received 139 responses describing prescribing practices from 40 countries. More than 50% of doctors said there is no restriction in prescribing for themselves and their relatives. A third of them said that they could even prescribe controlled drugs without any restriction. 56% said that one doesn't need a prescription to get antibiotics. When analysed by countries, 80% said that they could self-prescribe and in 50% of the countries, one could get antibiotics without a prescription. CONCLUSIONS: In many countries there is poor governance with regards to prescribing. This is due to a lack of restrictions on prescribing (both self-prescribing and for friends/family) and the public's ability to obtain antibiotics and controlled drugs.

What do physician associates think about independent prescribing?

Physician associates (PAs) are currently unable to prescribe in the UK due to the absence of statutory regulation and prescribing legislation. This is likely to change with the introduction of regulation by the General Medical Council (GMC) set to start from 2023. Currently, there are working groups looking into what needs to be done to enable them to prescribe. In this paper, we explored the views of PAs that qualified in the UK on prescribing and ordering investigations via an online questionnaire. Almost all PAs would prefer to be able to prescribe and request radiological investigations. Inability to perform these basic duties has a negative impact on patient care, patient flow, PAs' contribution to healthcare and career progression.

Is it appropriate to link 'old age' to certain causes of death on the medical certificate of cause of death?

In the current list of acceptable causes of death in the medical certificate of cause of death, some causes are either linked to old age or could be used for all people over the age of 80 years. Notable ones include 'frailty of old age', 'debility of old age' and 'senility'. It is best to avoid these terms as they provide an erroneous impression that these conditions occurred because a person was old; we recommend that the list of acceptable causes of death is revised by engaging all stakeholders.

What was the impact of COVID-19 on the foundation training programme in north Wales?

The ongoing COVID-19 pandemic has affected postgraduate medical training across the UK. We surveyed foundation trainees in north Wales, receiving responses from 29 of 134. 80% felt that alterations to their training had negatively impacted their learning. 43% felt their progression to speciality training will be negatively affected. 70% did not think they were adequately involved in the decision making process.

The contributions of NHS healthcare workers who are shielding or working from home during COVID-19.

During the COVID-19 pandemic, many healthcare staff and others who work for the NHS have been working from home (WFH) or shielding due to various health conditions, including pregnancy. While emphasis has been given to the support and wellbeing of those working at the frontline, little is known about the contribution of those who are working remotely. This online survey attempts to throw some light on how these healthcare workers have been contributing to the NHS while WFH, the resources they may or may not have to undertake their remote duties, their perception of whether their contribution is valued at the workplace, and their views on whether the new ways of working would influence the manner in which they would work in the future.